結核感染における加齢の影響 : 1,141名の喀痰塗抹陽性肺結核患者の疫学的研究 INFLUENCE OF AGING ON TUBERCULOSIS INFECTION : An Epidemiological Study of 1,141 Smear-positive TB Patients

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〔目的〕結核感染における加齢の影響を知る。〔対象と方法〕愛知県で新登録された1,141名の喀痰塗抹陽性肺結核患者の登録票を再点検し,感染経路を同じくする複数の発病者からなるクラスターを選別し,その最初の登録者を感染源患者(SC),それ以後の登録者を二次患者とし,SCの占める割合を感染源率(ESR)とした。〔結果〕感染源患者は70名,ESRは6.1%であった。10代から40代までのESRは13%以上で,50代は6.9%,60歳以上は4%以下であった。60歳で二分したESRは,60歳未満11.6%,60歳以上3.3%であった(p<0.001)。性,肺病変,G号数,感染危険度指数別の9区分で比較したところ,60歳未満のESRは60歳以上よりすべての区分で高かった。また,G号数の増加により60歳未満ではG1~4号6.3%,G5~8号15.3%,G9~10号32.4%と有意に増加したが,60歳以上では3.1%,3.9%,3.4%とほぼ同じであった。同様に,感染危険度指数10未満と10以上のESRは,60歳未満では8.0%,19.2%と有意に増加したが,60歳以上では3.1%,3.9%とほぼ同じであった。〔考察〕結核の感染源は主に喀痰塗抹陽性の肺結核であり,感染源率は,さまざまな因子により分けられた患者集団の感染力の強弱を表す。〔結論〕結核感染力は60歳以上で著しく弱まる。

[Objectives] To elucidate the influences of aging on the tuberculosis infection.<BR>[Subjects and M ethods] The subjects of this retrospective study were 1, 141 smear positive pulmonary tuberculosis (TB) patients registered in Aichi prefecture between 1989 and 2003. All registration files were reviewed to identify epidemiological links of patients. When linked patients with an interval of the dates of registration of less than 10 years were found, the earliest case was considered as the source case, and the other patients were regarded as secondary cases.<BR>An epidemic source rate (ESR) f or a category of patients (e. g., age-group, etc. ) was defined as following; ESR= <I>NS</I>/<I>NA</I>× 100, where <I>NA</I>: Number of smear-positive pulmonary TB patients in a category A, and <I>NS</I>: Number of source cases in category A.<BR>[Results] A tota l of 70 source cases were identifed and the ESR was 6. 1%. The ESRs for different age-groups were; 14. 3 % for 10-19 years of age (<I>NA</I> =14), 13. 5% for 20-29 years (<I>NA</I>= 7 4), 14. 6% for 30-39 years (<I>NA</I>= 48), 15. 0% for 40-49 years (<I>NA</I>= 107), 6. 9% for 50-59 years (<I>NA</I> =145), 3. 5 % for 60-69 years ( <I>NA</I> 227), 3. 8 % for 70-79 yea rs (<I>NA</I> =293), 2. 8% for 80-89 years (NA= 212), and 0% for 90? 99 years (<I>NA</I> =21). The ESR were significantly different between those aged 40 to 49 years and those aged 50 to 59 (p < 0. 05).<BR>The ESR was significantly different between those aged 59 years and younger and those aged 60 years or older (11. 6% vs 3. 3 %, p< 0. 001). The ESR was significantly different b etween those patients with cavitary lesion and those with noncavitary lesion in the younger groups (14. 3 % vs 5. 2%, p < 0. 01), as well as in the elder age-groups (4. 8% vs 1. 7%, p< 0. 01).<BR>The rate in the younger groups was 6. 3 % for those with lower smear-positivity (Gaffky 1 to 4), compared with 15. 3% for those with intermediate smear-positivitiy (Gaffky 5 to 8), and 32. 4% for those with higher smear-positivity (Gaffky 9 and 10) (with p< 0. 01, p< 0. 05 respectively), while the rates were 3. 1%, 3. 9%, and 3. 4%, respectively in the older groups.<BR>[Conclusion] These findings suggest that the infect ivity is significantly lower in older groups.

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  • 結核  

    結核 81(9), 567-571, 2006-09-15 

    JAPANESE SOCIETY FOR TUBERCULOSIS

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各種コード

  • NII論文ID(NAID)
    10018399549
  • NII書誌ID(NCID)
    AN00073442
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    00229776
  • NDL 記事登録ID
    8095325
  • NDL 雑誌分類
    ZS21(科学技術--医学--内科学)
  • NDL 請求記号
    Z19-133
  • データ提供元
    CJP書誌  CJP引用  NDL  J-STAGE 
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